enteroenterostomy

An enteroenterostomy is a surgical connection between two segments of the small intestine, typically the jejunum or ileum. The procedure is performed to reestablish intestinal continuity after removal of a diseased segment or to bypass a localized obstruction, allowing contents to pass between loops of bowel.

There are several anastomotic configurations. End-to-end, end-to-side, and side-to-side connections can be used, with hand-sewn or stapled techniques. The choice depends on the relative position and size of the bowel segments, the presence of edema, and surgeon preference. The goal is a tension-free, well-vascularized anastomosis with mucosa-to-mucosa apposition when feasible.

Indications include restoration of luminal continuity after segmental small-bowel resection, bypass of a stricture or obstructing lesion, and certain complex abdominal operations where reestablishment of flow between bowel segments is desired. Contraindications include hemodynamic instability, poor tissue perfusion, significant edema, extensive infection, or circumstances that prevent a tension-free, well-vascularized anastomosis.

Complications can include anastomotic leakage, intra-abdominal abscess or peritonitis, postoperative bleeding, anastomotic stenosis or obstruction, and fistula formation. Risk is influenced by nutritional status, contamination, tissue quality, and the presence of inflammatory or ischemic disease.

Overall, enteroenterostomy is a common and essential technique in small-bowel surgery, with outcome depending on patient factors, surgical technique, and the underlying condition necessitating the anastomosis.